Value of an early arteriographic acquisition for evaluating the splanchnic vessels as an adjunct to biphasic CT using a multislice scanner

• Published in: European radiology Vol. 13; no. 5; pp. 1072 - 1079
• Main Authors: Zandrino, F, Curone, P, Benzi, L, Musante, F
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01-05-2003
• Subjects: Angiography - standards; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - therapy; Chemoembolization, Therapeutic; Contrast Media; Hepatic Artery - diagnostic imaging; Hepatic Artery - pathology; Hepatic Veins - diagnostic imaging; Hepatic Veins - pathology; Humans; Image Processing, Computer-Assisted; Liver - blood supply; Liver - diagnostic imaging; Liver - pathology; Liver Neoplasms - diagnosis; Liver Neoplasms - therapy; Mesenteric Artery, Superior - diagnostic imaging; Mesenteric Artery, Superior - pathology; Portal Vein - diagnostic imaging; Portal Vein - pathology; Splenic Artery - diagnostic imaging; Splenic Artery - pathology; Splenic Vein - diagnostic imaging; Splenic Vein - pathology; Time Factors; Tomography Scanners, X-Ray Computed; Treatment Outcome; Vascular Diseases - diagnosis; Vascular Diseases - therapy; Vena Cava, Inferior - diagnostic imaging; Vena Cava, Inferior - pathology
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-002-1566-0

Our objective was to assess the clinical value of an early arterial scan for assessing the hepatic and mesenteric vasculature in patients with suspected primary or metastatic hypervascular liver disease undergoing multislice computed tomography. In 42 patients a very early arteriographic scan was performed before standard arterial and portal venous scans. Technical parameters of the very early acquisition were: 2.5-mm image thickness; table speed 15 mm/s; pitch 6; 120 kVp; 300 mA; 8.9-s scan time; cranio-caudal acquisition direction; 1.25-mm image interval reconstruction;16-s delay after injection of 110 ml of iodinated contrast agent at 5 ml/s; scan volume focused to image hepatic, splenic, and superior mesenteric arteries (SMA). Standard arterial and portal venous phases were performed with 5-mm image thickness, 15-mm/s table speed, pitch 6, 8- to 10-s scan time, 30- and 70-s delay. The three phases were performed during three different breath-holds. Axial, multiplanar reformatted, maximum intensity projection, and volume-rendering images were evaluated. Image quality was scored, and vascular abnormalities were recorded. Digital subtraction angiography (DSA) was performed in 17 patients. In 36 of 42 patients good-quality CT angiograms were obtained. In 9 patients 12 vascular abnormalities were found, all confirmed at DSA: 3 right hepatic arteries originating from the SMA, 2 left hepatic arteries from the gastric artery, 2 stenoses of the SMA, 1 independent origin of the hepatic and splenic arteries, 2 arteriovenous fistulas, and 2 aneurysms of the common hepatic artery and the SMA. This technique could add important information about vascular splanchnic anatomy which would be particularly useful for surgeons and interventional radiologists.